What should you know about bright red nappy rash?

Nappy skin stays warm and covered, so wetness, stool, rubbing and contact with fragranced products can weaken the skin barrier. Irritant dermatitis may look red and sore across the areas touching the nappy. A yeast rash can be a vivid red colour and may extend into the skin folds, sometimes with small separate spots around the main rash. Other causes include bacterial infection or an underlying skin condition, especially when the appearance is unusual or keeps returning.

Change nappies promptly, rinse with lukewarm water or use a fragrance-free cleanser, and pat rather than rub. Give the skin short periods of air exposure and apply a plain protective barrier recommended for babies. Avoid talcum powder, fragranced wipes and scrubbing. A clinician or pharmacist can advise whether an emollient approach such as Emollient Therapy is suitable, or whether Topical Antifungal Treatment is needed when folds are involved or yeast is suspected. Do not use steroid or antifungal products without age-appropriate advice.

Arrange an assessment if the rash is spreading, blistering, bleeding, crusting, very painful, or accompanied by fever, marked swelling or a baby who seems unwell. Seek prompt advice for sores around the eyes or mouth, pus, or poor feeding. A rash that does not start settling with careful nappy care, or that repeatedly returns, deserves review so the cause and treatment can be checked.

Ask whether the pattern fits irritation, yeast or infection; which barrier product and cleansing routine suit the child’s age; and how long to try the plan before returning. Mention recent antibiotics, diarrhoea, new wipes, creams or nappies, and show how quickly the rash changed.